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Posted: January 15, 2008

Greater Use of Statins Could Extend Lives of Elderly Heart Disease Patients

Treatment of older heart disease patients with statins reduces their death rate over five years by more than 20%, according to a research analysis involving nearly 20,000 patients.
"Statins continue to be underutilized in elderly patients because evidence has not consistently shown that they reduce mortality," Dr. Mark J. Eisenberg, at McGill University in Montreal, and co-authors wrote in summarizing their findings for the Journal of the American College of Cardiology. The fact that the elderly have been under-represented in clinical trials appears to be part of the problem, they said.
Researchers conducted a meta-analysis of nine randomized, placebo-controlled trials in which a total of 19,569 patients between the ages of 65 and 82 were tracked for an average of five years.
They found that the relative risk of death from all causes was reduced by 22%. However, death from coronary disease fell even further, with a relative risk reduction of 30%, and the relative risks of nonfatal myocardial infarct (MI), the need for revascularization, and the incidence of stroke decreased by 25% to 30%.
"These estimates are rigorous and precise, owing in large part to our Bayesian hierarchical model and larger sample size of elderly patients," the authors wrote.
More than 1 million Americans have heart attacks each year -- about one every 29 seconds. One third of the victims die before they reach a hospital.
Statins are a class of drugs primarily used to lower cholesterol. They lower the levels of LDL-cholesterol (the so-called bad cholesterol), and they lower LDL-cholesterol more than other types of drugs. These drugs work by slowing the production of cholesterol and by increasing the liver's ability to remove the LDL-cholesterol already in the blood. Lipitor, Zocor and Crestor are some of the more common statins.
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In an editorial accompanying the research findings, Dr. George A. Diamond and Dr. Sanjay Kaul, cardiologists at UCLA, said statins have proven "remarkably safe" and cost-effective in the elderly. Still, statin use has stagnated at 40% to 60% in elderly patients with heart disease, while the use of angioplasty "continues to increase despite the lack of equivalent evidence of outcomes benefit."

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